Therapy for ataxic patients is multi-modal and involves persons from different disciplines and with different types of expertise.
We advise patients with ataxia to work toward remaining in good general health by engaging in regular physical and mental exercise, eating and sleeping well, and avoiding injury from taking too much medicine, falling, or developing aspiration pneumonia. A primary care physician is essential for coordination of health care available for patients, encouragement of preventative health management, education of patients about avoidance of risks, and to guide the use of medications.
Patients with ataxia benefit from interaction with a neurologist for multiple reasons, including establishment and confirmation of diagnoses, to follow the progression of ataxia, and to learn of associated neurological or psychiatric dysfunction for which therapy may be beneficial. Related signs and symptoms may include spasticity, tremor, fatigue, myoclonus, dystonia, peripheral neuropathy, seizures, thinking and memory difficulties, and personality or mood disorders.
Pharmacological treatment has been beneficial in a small number of patients with specific ataxias and further research is ongoing worldwide. Examples of treatable ataxias include those due to deficiencies of vitamin E or coenzyme Q10 and Episodic Ataxia Type 2 (EA2), in which episodes of cerebellar dysfunction are reduced by acetazolamide treatment. Pharmacological treatment to stop or slow down the progression of most ataxias is limited and benefit has been reported only in small trials. Progression of ataxia in some patients has been slowed by amantadine (Botez and colleagues) and others have found amantadine to increase energy levels. Baclofen in low doses may reduce leg spasticity. GABAergic agents such as clonazepam, beta-blockers such as propranolol, or Primidone may reduce the prominence of some cerebellar tremors